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Aim: To measure the level of burnout and job satisfaction experienced by dental students and faculty at Princess Nourah Bint Abdulrahman University College of Dentistry (PNU), and to examine if there is an association between burnout and job satisfaction. Methods: The Maslach Burnout Inventory Human Services Survey (MBI) was used to measure burnout, and the Dentist Satisfaction Survey (DSS) was used to measure job satisfaction. Full-time faculty and fourth- and fifth-year dental students completed the MBI and DSS online. T-test comparisons were performed, and the emotional exhaustion (EE) subscore from the MBI and the overall DSS score were correlated. Results: The survey was sent to 65 students and 37 full-time faculty. A total of 31 student and 17 faculty surveys were available for analysis (response rate 48% and 46%, respectively). The mean EE was 19.24 for faculty and 28.45 for students, both indicating moderate burnout (p=0.0030). The mean overall DSS score was 3.35 for faculty and 3.03 for students, indicating “neutral” job satisfaction (neither satisfied nor dissatisfied, p=0.0345). EE was significantly negatively correlated with DSS (r= -0.73, p=<0.0001). Conclusion: Students and faculty at PNU are moderately burned out. Burnout is significantly negatively associated with job satisfaction.

Methods

Conclusions

Burnout and Job Satisfaction among Dental Undergraduates and Faculty By Dr. Shatha Subhi ALHarthi1 & Monika M. Wahi, MPH, CPH2

1Department of Periodontology, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia 2General Education Department, Laboure College, Milton, Massachusetts, United States of America

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Abstract Results

•  “Burnout describes a process beginning with high and sustained levels of stress resulting in feelings of irritability, fatigue, detachment and cynicism” (1).

•  Burnout has been documented in dentists. ² One study of dentists found that on average, dentists were

moderately burned out on two of the three subscales (2, 3). ² Another study of dentists Iran found the “frequency of

exhaustion, intense depersonalization, and intense feeling of being unsuccessful was 21.1%, 81.6%, and 100%, respectively” (4).

² A study of dentists in Kingdom of Saudi Arabia (KSA), and found that over a fourth of general dentists were suffering from high levels of emotional exhaustion (5).

•  Burnout has been shown in dental trainees as well. ² A systematic review of studies of stress in dental students found

that they experience considerable amounts of stress, mainly due to the demanding nature of the training, and the results of the studies suggest that there are adverse effects of elevated stress on students’ health and well-being (6).

² A 2014 study in Spain found that 43.1% of second-year students were burned out and 50.9% of fourth-year students were burned out, but only 25.6% of fifth-year students are burned out (7).

² A German study also found that dental students were on average moderately burned out (8).

•  Burnout reduces a healthcare provider’s commitment to his or her organization, and can increase his or her intention to leave the job (9). ² Mean overall job satisfaction in a Korean dentist study was only

3.2 out of 5, and patient relations, perception of income, personal time, staff, and specialty training, which can influence burnout, were important work environment factors influencing job satisfaction (10).

² A similar result was found in a study of Egyptian dentists, where mean job satisfaction was 3.24 out of 5 (11), and in Saudi dental assistants, where the mean job satisfaction was 3.86 out of 5 (12).

² Evidence to support the concept of undergraduate or graduate level dentists actually having a “job” and therefore being able to have “job satisfaction” could be seen by reading into the results of a study on postgraduate dentists who essentially were experiencing the same high level of stress as career dentists (13).

Introduction

•  At Princess Nourah Bint Abdulrahman University College of Dentistry (PNU), pre-doctoral students (“undergraduates”) are considered fourth-year and fifth-year students. ² These students are all from Saudi Arabia, with between 30 and

40 students in each class. •  There are approximately 40 full-time faculty members from Saudi

Arabia and other countries; these members fall into the following hierarchical position categories: Lecturer, Assistant Professor, Associate Professor, and Professor.

Setting

The objectives of the present study are: 1.  To characterize the levels of burnout experienced by fourth-year

dental students (4YR), fifth-year dental students (5YR), and dental faculty (FAC) at PNU, and examine if these levels differ by dental student or faculty characteristics,

2.  To characterize the levels of job satisfaction experienced by 4YR, 5YR and FAC at PNU and examine if these levels differ by dental student or faculty characteristics, and

3.  To examine if there is an association between burnout and job satisfaction in dental students and faculty in PNU.

Objectives

•  Students and faculty at PNU were sent an online, anonymous questionnaire asking questions from the MBI (to measure burnout) and the Dentist Satisfaction Survey (DSS, to measure job satisfaction).

•  The MBI has three subscales: Emotional Exhaustion (EE), Depersonalization (DP), and Personal Achievement (PA). See Table 1 for scoring rules.

•  The DSS has an overall score and seven subscales (see Table 2). These are all scored the same way.

Table 1. MBI Scoring Rules

MBI SubscaleLow-Level Burnout(LOW)

Moderate Burnout(MOD)

High-level Burnout

(HI)Emotional Exhaustion (EE) 17 or less 18 through

2930 or

greaterDepersonalization (DP) 5 or less 6 through 11 12 or

greaterPersonal Achievement (PA)

40 or greater

34 through 39 33 or less

Table 2. DSS Scoring Rules

DSS-29 Subscale Dissatisfied(DIS)

Neutral(NEU)

Satisfied(SAT)

All questions (overall score)Overall Job Satisfaction (O)Perception of Income (PI)*Personal Time (PET)Professional Time (PRT)Staff (S)Patient Relations (PR)Delivery of Care (DC)

Mean of 1.0 - 2.5 on indicated questions

Mean of >2.5 -<3.5 on indicated

questions

Mean of 3.5 - 5.0 on indicated questions

•  The survey was sent to 65 students and 37 full-time faculty. A total of 31 student and 17 faculty surveys were available for analysis (response rate 48% and 49%, respectively).

•  Table 3 shows demographic results for students who completed the survey, and Table 4 shows demographic results for faculty.

Table 3. Student Demographics

Table 5. Burnout and Job Satisfaction

•  Table 5 presents the mean MBI and DSS scores for students and faculty

•  For the MBI subscales, both faculty and students were moderately or highly burned out, but scores for students were significantly higher.

•  On most DSS subscales and the overall scale, students and faculty were neutral.

•  Students were significantly more dissatisfied with PET, and both students and faculty were satisfied with PR and DC.

•  Even though overall both faculty and students were neutral, faculty scores were significantly higher. They were also significantly higher for PR and DC.

Table 4. Faculty Demographics

Results, Continued •  EE and DP scores were high for both faculty and students, with

student scores significantly higher (see Figures 1 and 2).

Figure 1. EE Results

Figure 2. DP Results

•  Overall DSS score (see Figure 3) was significantly higher for faculty compared to students (p=0.0345).

•  EE was significant negatively correlated with overall DSS score (r= -0.73, p=<0.0001) (see Figure 4).

Figure 3. DSS Results

Figure 4. Scatterplot, EE vs. DSS Score

•  Both students and faculty at PNU are at least moderately burned out, and students may have a higher risk of burnout.

•  Both students and faculty have similar neutral job satisfaction, but are dissatisfied with the amount of personal time they have, and are satisfied with their patient relations and delivery of care.

•  Allowing students and faculty more personal time may improve both burnout and job satisfaction levels ² One possibility is limiting student workdays to up to 4 hours per

day, and limiting faculty workdays to up to 8 hours per day.

Burnout Results

Student(mean)

Student Level

Faculty(mean)

Faculty Level t-test

EE 28.45 MOD 19.24 MOD 0.0030DP 17.48 HI 11.82 HI 0.0261PA 33.45 MOD 38.24 MOD 0.0150

Job Satisfaction

ResultsStudent(mean)

Student Level

Faculty(mean)

Faculty Level t-test

Overall 3.03 NEU 3.35 NEU 0.0345O 3.24 NEU 3.63 SAT 0.7667PET 1.89 DIS 2.51 NEU 0.0392PRT 2.70 NEU 2.80 NEU 0.2472S 2.67 NEU 3.14 NEU 0.0360PR 3.78 SAT 4.16 SAT 0.0356DC 3.67 SAT 3.69 SAT 0.9202

Facultyn, %

Total Surveys 17, 100%

Age Group<18 0, 0%18-30 3, 18%31-40 8, 47%41-50 3, 18%51-60 2, 12%61+ 1, 6%Department

Preventive 1, 6%Clinical 7, 41%Basic 6, 35%Other 3, 18%

Faculty Level

Lecturer 4, 24%Assistant Professor 8, 47%Associate Professor 2, 12%Professor 3, 18%

Faculty Highest Level of

EducationBachelor's Degree 0, 0%Master's Degree 5, 29%Doctoral Degree 12, 71%Other 0, 0%Typical Work

Hours4 hours or less 0, 0%4 to 8 hours 9, 53%More than 8 hours 8, 47%

Studentsn, %

Total Surveys 31, 100%

Age Group<18 0, 0%18-30 31, 100%31-40 0, 0%41-50 0, 0%51-60 0, 0%61+ 0, 0%

Student Status

Fourth-year 21, 68%Fifth-year 10, 32%Typical Work

Hours4 hours or less 1, 3%More than 4 hours 30, 97%